September 5, 2009

One year ago, as a result of a running hip injury and a prior history of a hip stress fracture (running), my doctor recommended a bone density measurement even though I am young, active, and have no significant risk factors for osteoporosis. Obediently, I went for a DEXA measurement.

Shortly after, my doctor informed me that the good news was that I had not lost any height, but the bad news was that I had osteoporosis. I was shocked.

This diagnosis was opportunity to adjust my lifestyle to improve my long-term skeletal health. As with any significant emergent problem, the long view response is similar:

Assess priority – does it merit long view investment?

Define improvement/success metric(s)

Create a plan for improvement/success

Execute: drip, drip, drip…

Measure improvement/success

Reassess priority (Celebrate improvement/success)

Establishing priority was easy. To ensure my long-term skeletal health, I was immediately committed to aggressively battling this silent disease. Complacency was never an option for an Off-the-Scale-Futurist.

Defining the improvement/success metric was also easy. I needed to increase my bone density to greater than -1.5 spinal t-score (low end of the normal range) as measured by DEXA.

With my doctor, I created a threefold plan for bone density improvement/success:

Increase mineralization: add load-bearing exercise. This required a remix of my athletic lifestyle. My typical regimen of swimming, biking, running, and an occasional cardio machine provided limited load-bearing. Only running counted as load-bearing, and it only loads the lower skeleton. So, I reduced swimming and biking in favor of weight-lifting 2x/week, along with my usual running. After a bit, I realized the combination did not give me the joy of athletics to which I was accustomed, so I went in search of new load-bearing sports. I tried both yoga and rock climbing, both of which provide whole skeletal loading. Although I liked yoga, it didn’t like me (rhomboid strain). I loved rock climbing – it is so addictive that it became the clear winner! 🙂 I now mix a combination of swimming, biking, running, and rock climbing throughout the week, along with weight-lifting 1x/week. I still have joy, but I increased the amount of load-bearing exercise.

Since DEXA bone density is measured no more frequently than annually – I committed to a full year of execution. Keeping the faith, I impatiently and anxiously awaited my next DEXA results, drip, drip, drip, …

I recently received my results and I moved the needle! I went from a -2.6 spinal t-score to a -1.6 spinal t-score; a full standard deviation of change. Woohoo! Although I didn’t quite reach a number greater than -1.5, I certainly made a significant gain. Time to celebrate!

Because load-bearing is now integrated into my lifestyle, I no longer need aggressive focus. Time for a new adventure…

March 22, 2009

Today my best friends are my pillow, my teacup, and Mucinex-D (the elixir of cold comfort). Just like everybody else, I hate being sick. I hate the misery of congestion, coughing, and sniffling. I hate missing my Sunday morning run with my friends, missing a kid’s soccer game, and not making any progress against my “to do” list. However, all of those things are transient and insignificant in the long view.

I know without adequate rest, I will only get sicker. I have tested the “not slow down” strategy more than once and know unequivocally that it’s a loser. My two-year-old memory of walking pneumonia is still vivid! I am grateful that I have a family that will cover for me and allow me to rest. Today I am resting comfortably.

Each of us only gets one body. From an early age we are trained to care for ourselves — brush & floss our teeth, eat right, exercise regularly, and rest appropriately after illness or injury. Although most of us do all of these things regularly, it is the last one that can be the most vexing. It is challenging because injury and illness are inherently unplanned, undesirable, and unintended. Recovering from injury or illness requires expenditures of time and effort to recover that would not be required if everything had “gone to plan.” So there is opportunity to be bitter and angry. The reality is that there is risk in sports (one cause of injury) and being around others (one cause of illness transmission). It is the payoff: fun in sports or the creation/nurturing of a social/professional connection, that makes the risk worthwhile.

In an analogy to business, routine care is required for operations — develop products, purchase raw materials, manufacture products, sell products, account for the flow of money and products, and take time to recover from setbacks. As in illness or injury, setbacks require expenditures of time and effort that would not be required if everything had “gone to plan.” Similarly, there is risk in business — if it was easy, it would not be a long-term business. It is the payoff: money (in a for-profit business), that makes the risk worthwhile.

In both cases (body or business), routine care requires planning, precautions, and prudence. Yet these cannot prevent all setbacks; they minimize the severity, duration, and frequency. Thus, in order to be truly successful, we need to take the long view and be disciplined in our recovery from setbacks. We must expect setbacks, plan to expend time and effort to recover (relative to the risk of the payoff), and not be negative or rushed in our recovery execution. One way is to buffer projects from uncertainty by realistic planning, disciplined tracking, and adequate resource deployment for recovery using Goldratt’s Critical Chain, all the while staying, persistent, passionate, and positive!

On a personal level, I am working hard to recover an ankle sprain (a moment’s inattention to a pothole in a running trail left my ankle discolored, swollen, and sore). Since I want to enjoy the wind in my face (from running) for as long as I live (the long view), I am in rehab (toe-raises, gentle stretches, and swimming). Only nine (9) more days until I can run on my ankle again! But who is counting?!